Abstract: Cross-institutional Electronic Medical Records (EMRs) sharing significantly improves healthcare quality and reduces costs. Current EMRs are often stored on cloud servers and protected by Attribute-based Encryption (ABE) for access control. Cross-institutional sharing allows doctors to request EMRs access from target Healthcare Institutions (HIs) through attribute-based collaboration, enabling flexible and secure access. However, existing collaboration in practical EMRs sharing scenarios suffers from inefficiency, hindering timely access and treatment. This paper proposes an efficient and privacy-preserving data sharing framework for EMRs, called CARE-EMRs. CARE-EMRs enables efficient EMRs data access for doctors across different HIs through an outsourcing mechanism. Furthermore, we designed an improved cryptographic primitive PPD-CP-ABE to serve as the security foundation for CARE-EMRs framework, ensuring privacy of the outsourced process. We prove the security of CARE-EMRs. Performance analysis indicates that it significantly reduces the computation and communication overhead.
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